联合SWI及DTI对急性、亚急性弥漫性轴索损伤的诊断价值  

The Combination of SWI with DTI in Diagnosis of Acute and Subacute Diffuse Axonal Injury

作　　者：卢海涛[1] 邢伟[1] 陈杰[1] 丁玖乐[1] 秦华平[2] 张艳文[1] 

机构地区：[1]苏州大学附属第三医院放射科,常州213003 [2]苏州大学附属第三医院神经外科,常州213003

出　　处：《临床放射学杂志》2012年第8期1077-1081,共5页Journal of Clinical Radiology

摘　　要：目的探讨联合磁敏感成像(susceptibility weighted imaging,SWI)及扩散加权成像(diffusion tensor ima-ging,DTI)在急性、亚急性弥漫性轴索损伤(diffuse axonal injury,DAI)中的应用价值。方法 19例弥漫性轴索损伤(DAI)患者于急性或亚急性期(外伤后2周内)行头颅SWI、DTI及常规序列扫描,比较各序列对病灶显示的灵敏度。将检出的病灶数目与患者入院格拉斯哥昏迷评分(GCS)行相关性分析。结果 T2WI共检出DAI病灶128个,DTI-扩散图(TRACEW图)检出279个,SWI检出538个,联合SWI及DTI检出589个。SWI、DTI(TRACEW图)对DAI病灶的检出率均显著高于常规T2WI(Z=-3.764,Z=-3.245;P<0.01)。联合SWI及DTI两种技术对DAI病灶的检出显著高于单独应用DTI(Z=-3.551,P<0.01)或SWI(Z=-2.351,P<0.05)。联合SWI及DTI两种技术检出的病灶数目与患者入院GCS呈高度负相关(r=-0.775,P<0.01)。结论联合SWI及DTI两种检查技术,能够较单独应用一种技术观察到更多的DAI病灶,有助于较准确地对DAI患者的病情进行评估。三维扩散张量纤维束成像(diffusion tensor tracking,3D-DTT)还可以直观显示DAI患者脑白质纤维束的损伤情况。Objective To investigate the significance of Susceptibility Weighted Imaging（SWI） combinated with Diffusion tensor Imaging（DTI） in Diagnosis of acute and subacute Diffuse Axonal Injury.Methods Nineteen acute or subacute DAI patients underwent SWI,DTI and conventional MRI sequence examination.The sensitivity of each sequence in displaying lesions was compared.To correlation between the number of lesions and initial glasgow coma score（GCS）was analyzed.Results The number of lesions detected were 128,279,538,589 respectively on T2WI,DTI,SWI and combination SWI with DTI.The number of lesions detected by SWI and DTI was statistical more than that by conventional sequence（Z=-3.764,Z=-3.245;P〈0.01）.The number of lesions detected by combination SWI with DTI was statistical more than that by DTI（Z=-3.551,P〈0.01） or SWI（Z=-2.351,P〈0.05）.The number of lesions revealed by combination SWI with DTI was negatively correlated with GCS（r=-0.775,P〈0.01）.Conclusion Combination of SWI with DTI can display more DAI lesions than single SWI or single DTI,furthermore,can be used to estimate the condition of patients preferably.3D DTT may visual display the impaired fibers.

关 键 词：磁敏感加权成像 扩散张量成像 弥漫性轴索损伤 格拉斯哥昏迷评分 

分 类 号：R651.1[医药卫生—外科学]